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Prognosis of Bell's palsy in children--analysis of 29 cases
Wen-Xiong Chen1, Virginia Wong
1Division of Neurodevelopmental Paediatrics, Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulamg, Hong Kong SAR, China.
Insights
Bell
Area of Science:
- Pediatric Neurology
- Infectious Diseases
Background:
- Bell's palsy, a common cause of acute facial nerve paralysis, affects children.
- Limited research exists on the natural course and treatment efficacy in pediatric Bell's palsy.
Purpose of the Study:
- To analyze the clinical characteristics, recovery patterns, and treatment outcomes of Bell's palsy in children.
- To investigate factors influencing recovery duration, including viral or mycoplasma infections and steroid treatment.
Main Methods:
- Retrospective review of 32 Bell's palsy episodes in 29 children over an 8-year period (1995-2003).
- Analysis of clinical data, recovery times, virological/mycoplasma confirmation, and steroid treatment administration.
Main Results:
- The peak age of onset was under 3 years, with a 10.3% recurrence rate.
- Complete recovery was observed in 96.9% of episodes; recovery was prolonged in cases with viral or mycoplasma infections.
- No significant difference in recovery rates was found between children treated with steroids and those who were not.
Conclusions:
- Bell's palsy in children has a generally favorable prognosis, but recovery can be protracted in cases of viral or mycoplasma infection.
- Evidence-based trials are needed to guide treatment, rather than empirical steroid use, especially for prolonged recovery cases potentially linked to viral origins.
Abstract:
We report 29 children with 32 episodes of Bell's palsy admitted to a university affiliated hospital during an 8-year period (1995-2003). The peak age of onset was under 3 years. Three (10.3%) had recurrent attacks. Complete recovery occurred in all 32 episodes except 1 (3.1%) with partial recovery, having MRI evidence of parotitis shown in the contralateral side. The recovery rate within 3 weeks was 68.8%. There was statistically significant increase in the duration of complete recovery for those with positive virological confirmation or mycoplasma infection. There was no significant difference between the rate of recovery in those treated with a short course of steroid (N = 23 attacks) than those without steroid treatment (N = 9 attacks). As there were few studies in the natural course of children with Bell's palsy, evidence based trials should be done to assess the natural course rather than giving steroid empirically as those with more protracted recovery might be viral in origin.